Catholic Advocacy Day

Texas Advocacy Day - Youth Registration

To be completed by a parent/guardian
The Diocese of Corpus Christi invites you to be part of Catholic Advocacy Dayy on Tuesday, April 1, 2025, at 11:30 AM at the Texas State Capitol in Austin. This special day, organized by the Texas Catholic Conference of Bishops, brings together Catholics from across the state to pray and advocate for important issues with our legislators. Travel with us on a chartered bus with 50 seats available for this special day. The cost is $20 per person, which covers your seat reservation. As a bonus, every registered participant will receive a FREE T-shirt, so be sure to provide your shirt size when you register. This event is open to all adults and families in the Diocese of Corpus Christi, but please note that minors under 18 must be accompanied by a parent or guardian.
Childs Name*

First NameLast Name
Birthdate*

MonthDayYear
Date
Parish:*
Parent/Guardian Name:

First NameLast Name
Parent/Guardian Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/Guardian Phone*
Please enter a valid phone number.
Parent/Guardian Email*
example@example.com
PARENT/GUARDIAN PERMISSION & LIABILITY WAIVER
I, Parent/ Guardian Name* grant permission for my child, Child's Name* to participate in the Texas Advocacy Day on Tuesday, April 1, 2025, at 11:30 AM at the Texas State Capitol in Austin. This event would leave from JPII High Schoo (3036 Saratoga Blvd., Corpus Christi, TX 78415)l at 5:00 am to into Austin and return to JPII High School in the evening. Departing at 3:00pm and returning by 8:00pm.

As parent and/or legal guardian, I remain legally responsible for any personal actions taken by the above- named minor (“participant”). I would like my CHILD to participate in the above-named ACTIVITY.

In exchange, and for said consideration, as parent or legal guardian, I agree to defend and fully indemnify the above-named PARISH/SCHOOL and Diocese against any claim which results from the intentional or negligent actions taken of my CHILD during the above-named ACTIVITY. I further agree to fully indemnify and hold harmless the PARISH/SCHOOL and Diocese against any claim or cause of action whatsoever brought by my CHILD or his/her parent/legal guardian against the PARISH/SCHOOL which arose out of the above identified ACTIVITY, regardless of whether such claim results from the negligence of the PARISH/SCHOOL, its employees or volunteers or the negligence of individuals or companies not a party to this agreement.

Further, for said consideration, I hereby release and discharge the Diocese, its agents, servants, and employees, including the PARISH/SCHOOL, their employee(s), agents and representatives (parties being released) of and from all claims, demands, causes of action, and expenses arising out of or in any way connected with the employee of the PARISH/School.

I certify that I understand this agreement and the risks and hazards associated with the ACTIVITY described above that my CHILD will be participating in. I further understand that I had the opportunity to fully discuss this agreement with a representative of the PARISH/SCHOOL to clarify any concerns or questions about the activity or this agreement that I may have had.

PHOTO/VIDEO CONSENT: As a parent/guardian, I understand that photos/video of my child may be taken during this activity. I give permission for the taking of my child’s photo or video and for use of the resulting images and video for promotional purposes of the Diocese. This may include the right to use them in print, online, in social media, and in press releases.
Electronic Parent Guardian Signature*

Clear
Date*

MonthDayYear
Date
ADULT PARTICIPANT’S RELEASE OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AGREEMENT & MEDICAL INFORMATION
In consideration of the Parish/Diocese permitting to participate in the above event, I hereby:

RELEASE, DISCHARGE AND COVENANT NOT TO SUE THE ABOVE-NAMED PARISH/SCHOOL AND THE DIOCESE OF CORPUS CHRISTI FOR ANY AND ALL CLAIMS AND LIABILITY, WHICH CAUSES THE UNDERSIGNED INJURY, DEATH OR PROPERTY DAMAGE AND FURTHER AGREE TO HOLD RELEASEE(S) HARMLESS AND INDEMNIFY RELEASEE(S) FROM ANY CLAIM, JUDGMENT OR EXPENSE RELEASEE(S) MAY INCUR BY PARTICIPATION IN THE DESCRIBED ACTIVITY/FIELD TRIP.
Check the following*

I UNDERSTAND that participation in the described activity/field trip involves danger and risk of injury. The inherent danger is understood and voluntarily assumedI HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS.
In the event of an emergency please contact:
Emergency Contact Name*
Relationship*
Phone*
Secondary Phone
This may be a home or work phone number
Insurance Information
Health Insurance Carrier
Name of Insured
Insurance policy number
Or Select:

I do not have insurance at this time
I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A RELEASE OF ALL CLAIMS. I UNDERSTAND I ASSUME ALL RISK INHERENT IN THIS ACTIVITY. I VOLUNTARILY SIGN MY NAME EVIDENCING MY ACCEPTANCE OF THESE PROVISIONS. PLEASE SIGN BELOW.
Electronic Parent Guardian Signature*

Clear
Date*

MonthDayYear
Date
T-shirt Size

T-Shirts are available while supplies last
Please select one of the following t-shirt sizes:*

Adult SmallAdult MediumAdult LargeAdult XLAdult XXL
Payment

2025 Catholic Advocacy Day*

Registration for Catholic Advocacy Day

$20.00

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Total

$0.00

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Texas Advocacy Day - Youth Registration

PARENT/GUARDIAN PERMISSION & LIABILITY WAIVER

ADULT PARTICIPANT’S RELEASE OF LIABILITY, ASSUMPTION OF RISK, INDEMNITY AGREEMENT & MEDICAL INFORMATION

Insurance Information

T-shirt Size

Payment